Text-book of forensic medicine and toxicology

Chapter II: Medical Evidence Generally (2)

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Tailors work sitting, with the legs crossed and the body bent forward. The body is thus cramped, and the abdomen drawn in, and the thorax projects over it, due to the manner of sitting. They frequently have a soft red tumour on the external malleolus. A like tumour, but not so large, may also be found on the external edge of the foot, and a corn on the little toe.

Photographers have their fingers blackened by nitrate of silver, pyrogallic acid and other developers, or stained yellow with bichromate of potash.

Seamstresses have the index finger of the left hand roughened by the constant pricking of the needle.

Copyists have on the little finger of the right hand, near its extremity, a corn, and at the end of the middle finger a hard groove made by the pen.

Violinists have corns on the tips of the fingers of the left hand, harpists on both hands.

In smokers of pipes the incisors and canines are more or less worn by the mouthpiece, but sometimes the groove is between the canines and bicuspids. In cigarette smokers, the forefinger and thumb are stained with tobacco juice, also between the index and middle fingers, on the dorsum.

In coachmen, corns may be formed between the thumb and index finger, and between the index and the second finger of the left hand, from the pressure of the reins, and between the thumb and index finger of the right hand, from the pressure of the whip.

In bricklayers, from the constant action of picking up bricks, the flattening of the tip of the thumb and index finger of the left hand is not uncommon.

Plasterers have corns on the external surfaces of the thumb and index finger, due to grasping the “hawk” on which the plaster is placed during their work.

Joiners and carpenters have callosities on the palm of the right hand from grasping their tools, and between the thumb and index finger of the right hand, also over the first interphalangeal joint of the right index finger. The right shoulder is lower than the left.

The finger-ends of turners and coppersmiths are also more or less flattened; in the latter, a deposit of the metal may take place.

=To ascertain the time which may have elapsed since death.=--This can scarcely be determined with precision, as so much depends upon the conditions under which the body may have been placed. The subject under consideration is, therefore, beset with difficulties, and its elucidation will require the greatest care on the part of the medical expert. A careful attention, however, to the subjects treated in the following pages will help to clear up many a doubtful point.

COOLING OF THE BODY

{ Covered by bed-clothes, or otherwise
(1) External { unexposed, when cooling will be dry
circumstances. { slower than in cold air quickly moving.

(2) Condition of the }
body itself. } Slow, if fat.

{ 1. Wasting diseases. Quick.
{ 2. Suffocation. Slow.
(3) Kind of death. { 3. Cholera, yellow fever, } Increase
{ rheumatic fever, and } of heat
cerebro-spinal meningitis. } after death.

The following circumstances must also be taken into consideration: (1) Age. (2) Air--(_a_) moving; and (_b_) at rest. (3) Moisture. (4) Warmth. (5) Nature of the supposed cause of death, as affecting cooling of the body, and promoting the rapid advance of putrefaction. (6) Presence or absence of the _rigor mortis_. Bodies may be preserved for months if exposed to intense cold.

The following Table, compiled from the experiments of Devergie, may be of use in aiding the expert to form his opinion, but it must be borne in mind that, from the great difficulties which surround the subject, the statements made are only approximately correct. The table is divided into four stages or periods, the last being that in which putrefaction commences:--

First.--_From a few minutes to twenty hours after
death_--Animal heat more or less present, but seldom
continuing longer than ten or twelve hours. Muscles
contract on the application of galvanic stimuli, and
in the earlier stage to blows.

Second.--_From ten hours to three days_--Body quite cold and
_rigor mortis_ well marked; muscles do not contract on
the application of stimuli. The age, mode of death,
and other collateral circumstances must, more or less,
be taken into consideration before an opinion can be
given.

Third.--_From three to eight days_--The body is quite cold,
and cadaveric rigidity has passed off. The muscles no
longer respond to any galvanic or mechanical stimulus.
The stage is modified and somewhat shortened in summer.

Fourth.--_From six to twelve days_--Commencement of
putrefaction. Putrefaction may, however, take place
on the first or second day after death; so that, as
before stated, care must be taken before any positive
decision can be given.

Stature.--As a general rule the length of the body is equal to the distance between the tips of the middle fingers with the arms outstretched. If an arm be missing, the length of the remaining one multiplied by two, with the addition of 6 inches for each clavicle and 1½ inches for the width of the sternum, will give the approximate height. The femur is said to be equal to .275 of the body height. If the skeleton be entire, the addition of 1½ inches for the soft parts should be made.

Where only a limb or long bone or part of one be available, it is not possible to give anything more than an approximate opinion of the height.

Sex.--When mutilation, putrefaction, or charring has taken place, by which the genitalia have been demolished, it may be difficult to determine the sex. Evidence will be afforded by the distribution of the pubic hair, which in the male reaches as high as the umbilicus, but is horizontal with few exceptions in the female. Males have more hair on the body generally.

The presence of moustachios and beard and the length of the hair on the head will assist in sex determination.

The breasts if present will denote the sex, also the uterus, which withstands putrefaction and burning to a marked degree.

Remains of clothing and ornaments will indicate the sex of the wearer.

Lineæ albicantes on the abdomen, buttocks, and breasts indicate the female sex, and the probable occurrence of previous pregnancies. It must, however, be remembered that lineæ albicantes occur in males who have been stout or had the abdomen distended by disease.

The Skeleton in Relation to Identification.--When a complete skeleton is submitted for examination, the chief points to elucidate are the age and sex. These will be noted further on. It may happen that a single bone, separate bones, or only a part of one is obtainable, when there may be considerable difficulty in expressing a definite opinion. The questions to be answered are: Are they human or belonging to the lower animals? When the bones are entire the answer is not very difficult to settle; but when parts of bones have to be dealt with, one has to be very careful in forming conclusions, and the fragments may have to be submitted, to a skilled anatomist. One may not be able to express an opinion about bones of the lower animals, other than to state they are not human. The services of a skilled Comparative Osteologist may be necessary to decide the nature of the animal.

When fragments resembling bone have to be examined, the microscope will be necessary to determine their osseous structure. When several bones have to be examined it may be possible to build up part or the whole of a skeleton. Duplicate bones will indicate remains of more than one creature. All fragments and bones should be carefully described, measured, and photographed.

By the character of the bones one may be able to determine the sex to which they belong and the approximate age. As a general rule the bones of the female are smaller, lighter, and less marked by muscular and other attachments.

The thorax in the female is deeper than in the male, the sternum shorter and more convex, the ensiform cartilage thinner and ossified later in life. The cartilages of the ribs are larger and the ribs smaller than in the male. The ribs are more oblique and may show the results of long corset pressure. The body of the sternum is over twice the length of the manubrium in the male, less than this in the female.

The length of the twelfth rib in the male averages 103 mm., in the female 83.8 mm. The pelvis exhibits marked differences. The sacrum of the male is more curved than that of the female, which is straighter in the upper half and more curved in the lower. The male pelvis is more compact, deeper, rougher, and narrower. The pubic angle is smaller, the obturator foramen is oval, and the ischia incurved. The female pelvis is more open, shallower, wider, not so rough, a wider pubic angle, and shallower and broader symphysis, the ischia are everted, wider apart and flatter, and the obturator foramen triangular. The inlet of the female pelvis is greater in all its diameters.

The skull in the male is heavier and larger, the markings and ridges being more pronounced, the mastoid processes, occipital protuberance, zygomatic and superciliary ridges are more prominent, and the capacity greater than in the female.

In the female the jaw is less prominent and has a wider angle.

The lumbar curve is longer in the female, and the lumbo-sacral angle greater than in the male.

The angle made by the neck of the femur with the shaft is about a right angle in the female, more obtuse in the male. It must be remembered that these differences between the sexes are not present to the same degree before puberty, so that prior to it the examination offers little evidence as to sex.

When examining bones any injuries to their structure or other abnormalities should be noted. The skull must be carefully examined for fractures, especially the base, which may be easily overlooked. Injuries to vertebræ should be looked for. The presence of callus will indicate that fracture has occurred at a period before death long enough for its formation.

Age.--There are several data which enable one to form a fairly accurate opinion as to the age of a body, these are especially useful in earlier years and intra-uterine life.

The more general are the size, height, development, the presence or absence of signs of puberty, the state of dentition, the greyness of the hair; in the female the atrophic condition of the uterus after the menopause, and the character of the lower jaw.

In addition are the time of life at which centres of ossification appear and the union of epiphyses to the shafts of bones and bones with each other.

In intra-uterine life centres of ossification appear by the end of the sixth month in the os calcis, manubrium, and the bodies and laminas of the sacral vertebræ; by the seventh, in the first piece of the body of the sternum and the astragalus; by the eighth, in the second piece of the body of the sternum; at full term in the cuboid, third piece of the sternal body, first coccygeal vertebra, and the lower epiphysis of the femur.

All traces of the fontanelles have disappeared by the end of the fourth year. The angle of the jaw in infants and young children is obtuse; as dentition proceeds, the body becomes deeper and the angle alters so that towards adult life it approaches a right angle, the ramus is longer and the body has become well developed with a mental foramen midway between upper and lower borders. In the new-born, the mental foramen is low down as the body of the jaw is practically all alveolar. In old people the angle again becomes obtuse and the alveolus disappears as the teeth are shed, and the mental foramen is at the upper border.

Table of the Eruption of the Teeth

Age--Eruption of teeth.
Lower central incisors, 7 months. }
Upper “ “ 8 “ }
“ lateral incisors, 7-10 “ }
Lower “ “ 10-12 “ } Temporary.
First molars, 12-14 “ }
Canine teeth, 18 “ }
Second molars, 22-24 “ }

First molars, 6 years. }
Middle incisors, 7 “ }
Lateral incisors, 8 “ }
First bicuspids, 9 “ }
Second bicuspids, 10 “ } Permanent.
Canines, 11-12 “ }
Second molars, 12-13 “ }
Wisdom teeth, 18-25 “ }

Examine the lower jaw. The ramus forms an obtuse
angle in full-grown fœtus, a right angle in adult
life, obtuse in old age from loss of teeth.

Table showing the Periods at which Points of
Ossification appear after Birth

Years of Life. Bones in which Centres of Ossification appear.
1. Fourth piece of the body of the sternum; coracoid process
of scapula; head of humerus; os magnum (carpus);
head of femur; upper end of tibia; external cuneiform
(tarsus).
2. Lower end of radius; unciform (carpus); lower end of tibia;
lower end of fibula.
3. Great tuberosity of humerus; patella; internal cuneiform
(tarsus).
3-4. Upper end of fibula.
4. Great trochanter (femur); middle cuneiform (tarsus).
4-5. Scaphoid (tarsus); lower end of ulna.
5. Lesser tuberosity (humerus); internal condyle (humerus);
trapezium and semi-lunar (carpus).
5-6. Upper end of radius.
6. Scaphoid (carpus).
7. Trapezoid (carpus).
10. Upper end of ulna.
12. Pisiform (carpus).
13-14. External condyle (humerus); small trochanter (femur).

Periods of Union of Epiphyses with the Shafts of Bones,
and of Bones with each other

Years of Life.
1-2. Symphysis of lower jaw.
2. Frontal suture; unites from below upwards; it may persist.
Anterior fontanelle filled up.
7-8. Rami of ischium and pubes.
17. Epiphyses of upper end of ulna; small trochanter (femur).
17-18. Epiphyses of condyles (humerus); upper end of radius.
18. Epiphyses of great trochanter of femur; lower end of tibia;
lower sacral vertebræ; portions of acetabulum united.
19. Epiphyses of the head of the femur.
20. Epiphyses of the head of the humerus; lower end of radius
and ulna.
21. Epiphyses of the upper end of tibia; lower end of fibula.
24. Epiphyses of upper end of fibula.
25. Second and third pieces of sternum; first and second sacral
vertebræ; epiphyses of clavicle, lower end of femur.
40. Manubrium, with body of sternum.

Table giving the Measurements, according to the Months, of the
Extremities of the Fœtus in the Order of their Development
+-------+-----------+----------+------------+---------+------------+
| | Third. | Fourth. | Fifth. | Sixth. | Seventh. |
+-------+-----------+----------+------------+---------+------------+
|Humerus| 3½ lines.| 8 lines.|13-15 lines.|16 lines.|20-22 lines.|
|Radius | 2½ “ | 8 “ | 12 “ |16 “ | 17 “ |
|Ulna | 3 “ | 8 “ | 13 “ |17 “ | 18 “ |
|Femur |2-3 “ |4-5 “ | 12 “ |17 “ |19-21 “ |
|Tibia |2-3 “ |4-5 “ | 12 “ |17 “ |19-21 “ |
|Fibula | 2½ “ | . . . | 12 “ |17 “ |19-21 “ |
+-------+-----------+----------+------------+---------+------------+

+-------+------------+------------------+
| | Eighth. | Full Period. |
+-------+------------+------------------+
|Humerus|23-24 lines.|3 inches. |
|Radius |18-19 “ |2 “ 8 lines.|
|Ulna |22-23 “ |2 “ 10 “ |
|Femur | 24 “ |3 “ 6 “ |
|Tibia |21-23 “ |3 “ 2 “ |
|Fibula |21-23 “ |3 “ 1 “ |
+-------+------------+------------------+

Table showing the Maximum and Minimum Dimensions of the Osseous
Nucleus of the Inferior Femoral Epiphysis from the Seventh Month of
Intra-Uterine Life to Two Years after Birth
+------------+-------------+------+-----------------------------------------+
| |INTRA-UTERINE| | EXTRA-UTERINE. |
| | | | +-------------------+ |
| | | | | | |
| | | | Days. Months. |
| +-------+-----+ +-----------------+-----------------------+
| |Seventh|Ninth|Mature| 1-8 9-15 16-28| 1 3-6 7-12 12-24|
| +-------+-----+------+-----+-----+-----+-----+-----+-----+-----+
| | |lines| lines|lines|lines|lines|lines|lines|lines|lines|
+------------+-------+-----+------+-----+-----+-----+-----+-----+-----+-----+
|Maximum | | 2 | 4 | 3½ | 3½ | 2½ | 5 | 4 | 8 | 7 |
|Minimum | | “ | ¾ | 1 | ¾ | 1½ | 2 | 2 | 3 | 5 |
| | | | | | | | | | | |
| No. of } | | | | | | | | | | |
|Children}125| 31 | 9 | 52 | 8 | 3 | 2 | 9 | 3 | 6 | 2 |
|examined} | | | | | | | | | | |
+------------+-------+-----+------+-----+-----+-----+-----+-----+-----+-----+

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Text-book of forensic medicine and toxicologyChapter II: Medical Evidence Generally (2)

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